国产利培酮（索乐）治疗精神分裂症多中心开放性临床研究

目的：评价国产利培酮（索乐）治疗精神分裂症的疗效和安全性。方法：通过对全国45家精神病医院的962例精神分裂症患者进行多中心,大样本,开放性的为期8周的治疗观察。采用PANSS、CGI、SAS和TESS评定疗效和不良反应。结果：国产利培酮（索乐）对精神分裂症总有效率84.3%,临床总体疗效肯定,不良反应轻,主要是轻度的锥体外系反应,体重增加,因其程度轻,病人基本能耐受。结论：国产利培酮（索乐）对精神分裂症阳性症状及阴性症状均有效,起效快,安全性高,患者对该药依从性好,可作为精神分裂症的首选药物之一。     

Toll-like receptors and their role in host resistance to Toxoplasma gondii

Toxoplasma gondii and other apicomplexan parasites are widely distributed obligate intracellular protozoa. A critical host mediator produced in response to T. gondii infection is IL-12. This cytokine is synthesized by dendritic cells, macrophages and neutrophils and plays a pivotal role in the production of IFN-gamma, which in turn activates anti-microbial effector cells. In the past several years, many of the receptors and signaling pathways that link pathogen detection to induction of IL-12 have been identified and characterized. Among these receptors the Toll-like receptor (TLR) family can recognize all classes of pathogens and induce different types of immune responses. In the following review, I summarize the evidence for specific TLR function in host resistance to T. gondii.     

The presence of leukaemia‐associated phenotypes is an independent predictor of induction failure in acute myeloid leukaemia

Immunophenotyping of acute myeloid leukaemia (AML) has controversial implications with regards to prognosis. The aims of the present study were to determine the frequency of leukaemia‐associated phenotypes (LAP) in AML and to correlate their presence with response to induction chemotherapy. We analysed bone marrow samples at diagnosis from 84 AML patients using triple staining flow cytometry with routine standard panel of monoclonal antibodies. The association of LAP and response to induction chemotherapy was evaluated retrospectively. LAP were observed in 54 (64%) patients: lineage infidelity in 19 (35%), asynchronous antigen expression in 28 (52%), and lack of expected lineage specific antigens in 19 (35%). Significant correlation was found between LAP and responses to induction chemotherapy. Response to induction chemotherapy was more frequent in the absence of LAP (P < 0.05, estimated risk ratio of 1.6, 95%CI, 1.0–2.6) in a multivariate analysis. In conclusion, our data show the presence of LAP in AML is an independent predictor for response to induction chemotherapy and risk of relapse and should be considered for counselling patients and planning therapy.     

Severe bacteremia results in a loss of hepatic bacterial clearance

RATIONALE: Although it has been postulated that liver injury results in impaired clearance of bacteria from the blood, no prior study has evaluated hepatic bacterial clearance during sepsis. OBJECTIVES: We hypothesized that liver injury during the evolution of sepsis would result in impaired hepatic bacterial clearance. METHODS: Mild and severe bacteremia were generated in C57BL/6 mice by low- and high-dose intratracheal inoculation with Pseudomonas aeruginosa. MEASUREMENTS AND MAIN RESULTS: The mortality rates with mild and severe bacteremia were 20% and 60%, respectively. Hepatic bacterial clearance was preserved throughout the evolution of mild bacteremia but was lost late with severe bacteremia. The loss of hepatic bacterial clearance resulted in increased systemic bacteremia and mortality. Pretreatment with a caspase inhibitor resulted in preservation of hepatic bacterial clearance with severe bacteremia and eventual control of the bacteremia. When Kupffer cells were ablated before the onset of bacteremia, there was a loss of hepatic bacterial clearance. This converted an initially mild bacteremia into severe bacteremia with increased organ injury and mortality. CONCLUSIONS: These observations suggest that hepatic bacterial clearance may be lost during the evolution of sepsis, resulting in a failure to control bacteremia. Thus, the capacity of the liver to clear bacteria is an important determinant of the outcome in sepsis.     

Twelve-year follow up of a randomized prospective trial comparing bacillus Calmette-Guerin and epirubicin as adjuvant therapy in superficial bladder cancer

AIM: To compare bacillus Calmette-Guerin (BCG) with epirubicin in adjuvant therapy of superficial bladder transitional cell carcinoma, with respect to recurrence, progression and survival. Prognostic factors are also evaluated. METHODS: Between October 1991 and September 1999, all patients harboring superficial bladder cancers (Ta or T1) with any of the relevant criteria (stage>a, grade>1, size>1 cm, multiple or recurrent tumors), after complete transurethral resection were randomized to receive either 81 mg Connaught strain BCG or 50 mg epirubicin. Patients with recurrences were eligible to crossover, even repeatedly, until progression. Recurrence, progression and survival were analyzed in relation to initial treatment, patient characteristics and tumor characteristics. RESULTS: There were 209 patients included in the study, 149 men and 60 women. The mean age was 69.9 years (range, 24-92). The BCG group consisted of 102 patients and the epirubicin group contained 107 patients. Final analysis was made at a median follow up of 23, 47 and 61 months for recurrence, progression and survival, respectively. The 10-year Kaplan-Meier estimates for recurrence-free, progression-free and disease-specific survival were 61%, 78% and 80%, respectively, for the BCG group. The corresponding figures were 32%, 74% and 92%, respectively, for the epirubicin group. Time to recurrence differed significantly between two treatment groups (P=0.0004). Multiplicity increased the risk of recurrence, while grading influenced recurrence, progression and disease specific survival. CONCLUSIONS: Bacillus Calmette-Guerin prolonged time to recurrence when compared with epirubicin. Grading was shown to be a universal prognostic factor for recurrence, progression and disease specific survival.     

幼儿第二语言(外语)获得成效之多因素研究

【目的】 从语言和认知发展的角度研究幼儿第二语言的获得，探讨童学习外语的成效。【方法】 选择18～24个月、3-6岁正常幼儿，评价儿童的一般情况、语言发育水平(幼儿语言筛查表，WPPSI语言部分和PPVT)、中文和英文的语音分辨测验、英文发音准确性、记忆能力和英文学习成绩。研究的第一阶段为语音输入，18～24个月幼儿被分为两组，分别给予100h的中文和英文的语音输入。第二阶段，所有儿童参加14周的英语教学和测验。【结果】 70．9％儿童的家长重视学英文，高于重视中文获得的比例。是否经常听儿童磁带与中文词汇量有显著的正相关。英语成绩：女孩显著高于男孩；与年龄、中文和英文的语音分辨能力、WPPSI语言和PPVT的原始分、记忆能力呈显著的正相关。英语发音的准确性与年龄和中文语音分辨能力有显著的正相关。【结论】 幼儿学习L2：①应充分重视母语的发展；②无需从幼儿早期开始，在学龄前学习成效随年龄而提高；③女童的语言能力强于男童。④语音训练应考虑年龄和方法。